Spring applied phosphorus loss with cover crops in no-till terraced field.

Cover crops (CC) can improve phosphorus (P) cycling by reducing water related P losses and contributing to P nutrition of a rotational crop. This is particularly important in claypan soils with freeze-thaw cycles in early spring in the Midwest U.S. This 4-year study (2019-2022) examined the impact of CC monoculture and mix of CC species on P losses from a fertilizer application, and determined the P balance in soil compared to no cover crop (noCC). The CC mix consisted of wheat (Triticum aestivum L.), radish (Raphanus raphanistrum subsp. Sativus), and turnip (Brassica rapa subsp. Rapa) (3xCCmix) in 2019 and 2021 before corn, and cereal rye (Secale cereale L.) was planted as monoculture before soybean in 2020 and 2022. The 3xCCmix had no effect on total phosphorus (TP) and dissolved reactive phosphorus (PO4-P) concentration or load in 2019 and 2021. Cereal rye reduced TP and PO4-P load 70% and 73%, respectively, compared to noCC. The variation in soil moisture, temperature, and net precipitation from fertilizer application until CC termination affected available soil P pools due to variability in CC species P uptake, residue decomposition, and P loss in surface water runoff. Overall, the P budget calculations showed cereal rye had 2.4 kg ha-1 greater P uptake compared to the 3xCCmix species which also reduced P loss in water and had greater differences in soil P status compared to noCC. This study highlights the benefit of CCs in reducing P loss in surface runoff and immobilizing P through plant uptake. However, these effects were minimal with 3xCCmix species and variability in crop residue decomposition from different CC species could affect overall P-soil balance.

Neuroprotective potential of formononetin, a naturally occurring isoflavone phytoestrogen.

The increased prevalence of neurological illnesses is a burgeoning challenge to the public healthcare system and presents greater financial pressure. Formononetin, an O-methylated isoflavone, has gained a lot of attention due to its neuroprotective potential explored in several investigations. Formononetin is widely found in legumes and several types of clovers including Trifolium pratense L., Astragalus membranaceus, Sophora tomentosa, etc. Formononetin modulates various endogenous mediators to confer neuroprotection. It prevents RAGE activation that results in the inhibition of neuronal damage via downregulating the level of ROS and proinflammatory cytokines. Furthermore, formononetin also increases the expression of ADAM-10, which affects the pathology of neurodegenerative disease by lowering tau phosphorylation, maintaining synaptic plasticity, and boosting hippocampus neurogenesis. Besides these, formononetin also increases the expression of antioxidants, Nrf-2, PI3K, ApoJ, and LRP1. Whereas, reduces the expression of p65-NF-κB and proinflammatory cytokines. It also inhibits the deposition of Aß and MAO-B activity. An inhibition of Aß/RAGE-induced activation of MAPK and NOX governs the protection elicited by formononetin against inflammatory and oxidative stress-induced neuronal damage. Besides this, PI3K/Akt and ER-α-mediated activation of ADAM10, ApoJ/LRP1-mediated clearance of Aß, and MAO-B inhibition-mediated preservation of dopaminergic neurons integrity are the major modulations produced by formononetin. This review covers the biosynthesis of formononetin and key molecular pathways modulated by formononetin to confer neuroprotection.

Role of hyperbaric oxygen therapy in patients with inflammatory bowel disease.

PURPOSE OF REVIEW: Hypoxia is a known contributor to inflammation in inflammatory bowel diseases (IBD), and a growing interest has emerged in pharmacologically targeting hypoxia response pathways to treat IBD. The most basic form of treatment for hypoxia is delivering higher amounts of oxygen to the intestinal mucosa. In this review, we summarize the evidence in support of hyperbaric oxygen therapy (HBOT), a mechanism to deliver high amounts of oxygen to tissue, for treating IBD. RECENT FINDINGS: Two phase 2 clinical trials in hospitalized ulcerative colitis patients suffering from moderate-to-severe flares have demonstrated that HBOT improves responsiveness to steroids and avoidance of rescue medical and surgical therapy. Outpatient cohort studies in perianal fistulizing Crohn's disease and fistulizing complications of the pouch have demonstrated improved healing, particularly for complex fistulae. Several systematic reviews have now been completed, and HBOT has been observed to be well tolerated with low rates of adverse events. SUMMARY: HBOT may be considered as an adjunctive treatment for hospitalized ulcerative colitis flares and Crohn's disease-related fistulae. Higher quality trials are needed to confirm efficacy.

A qualitative study to explore the ethnomedicine practices towards hepatitis among the Irula traditional healers in Tamil Nadu, India.

Introduction: Irulas are known for their traditional medicine and healing practices. Ethnomedicine primarily describes the traditional medical approaches that take consideration of the cultural perspectives on health, illness, disease while addressing the delivery of healthcare and therapeutic modalities. The current study explores the ethnomedical practices towards hepatitis among the Irula traditional healers in Tamil Nadu. Methodology: A Community-based in-depth interview (IDI) study was conducted among eight traditional healers (5 males and 3 females) from Irula settlements in Dharmapuri, Kancheepuram, and Chengalpattu districts. Apart from traditional healers, 11 Irula adults were interviewed to understand their cultural perspectives on health and illness. Results: The major themes that emerged from the codes were the perception towards traditional healing and the process of treatment on hepatitis, the list of important conditions treated by the traditional healers, and the list of medicinal plants used for treating people. Conclusion: This qualitative study highlights the voices of the Irula tribal community and offers a rich source of information about ethnomedicine practices towards hepatitis among the Irula traditional healers in Tamil Nadu, India.

Association of clinically significant weight loss with number of patient visits and months of attendance at an Australian multidisciplinary weight management clinic.

Despite the obesity epidemic, there are relatively few multidisciplinary obesity services in Australia, and only limited data on the effectiveness of these services. The aim of this study was to evaluate the effectiveness of a university hospital-based weight management clinic-the 'Healthy Weight Clinic' in supporting patients to achieve clinically significant weight loss (≥5% reduction in body weight), weight maintenance, and changes in body composition. A retrospective review was conducted to determine weight and associated health outcomes in patients who attended an initial consultation in the first 2 years of the clinic-between March 2017 and March 2019. Follow up was at least 1 year for all patients. Patients who underwent bariatric surgery were excluded. Of 213 total patients, 172 patients attended more than one follow-up consultation for lifestyle modification. Mean weight change and percentage total weight change at last follow-up was -6.2 kg (SD 7.4) and - 6.0% (SD 6.9), respectively. For every additional clinic follow-up, there was 21.4% increased odds of achieving clinically significant weight loss, and for every additional month of follow-up, there was 10.1% increased odds of achieving clinically significant weight loss. Twenty percent of patients (34/172) maintained ≥5% of initial body weight loss for at least 1 year. Body composition measurements were also favourable, with significant changes in percentage skeletal muscle mass of +0.8% (SD 1.5) and in percentage fat mass by -1.4% (SD 3.2). Regular support in a structured holistic multidisciplinary obesity service enables patients to achieve clinically meaningful weight loss and improved skeletal muscle mass to body fat ratio, and maintain this loss for at least 1 year. Improved weight loss was associated with more patient visits and longer duration of attendance at the clinic.

Correction of Temperature Variation with Independent Water Samples to Predict Soluble Solids Content of Kiwifruit Juice Using NIR Spectroscopy.

Using the framework of aquaphotomics, we have sought to understand the changes within the water structure of kiwifruit juice occurring with changes in temperature. The study focuses on the first (1300-1600 nm) and second (870-1100 nm) overtone regions of the OH stretch of water and examines temperature differences between 20, 25, and 30 °C. Spectral data were collected using a Fourier transform-near-infrared spectrometer with 1 mm and 10 mm transmission cells for measurements in the first and second overtone region, respectively. Water wavelengths affected by temperature variation were identified. Aquagrams (water spectral patterns) highlight slightly different responses in the first and second overtone regions. The influence of increasing temperature on the peak absorbance of the juice was largely a lateral wavelength shift in the first overtone region and a vertical amplitude shift in the second overtone region of water. With the same data set, we investigated the use of external parameter orthogonalisation (EPO) and extended multiple scatter correction (EMSC) pre-processing to assist in building temperature-independent partial least square regression models for predicting soluble solids concentration (SSC) of kiwifruit juice. The interference component selected for correction was the first principal component loading measured using pure water samples taken at the same three temperatures (20, 25, and 30 °C). The results show that the EMSC method reduced SSC prediction bias from 0.77 to 0.1 °Brix in the first overtone region of water. Using the EPO method significantly reduced the prediction bias from 0.51 to 0.04 °Brix, when applying a model made at one temperature (30 °C) to measurements made at another temperature (20 °C) in the second overtone region of water.

A Web-Based Platform on Coronavirus Disease-19 to Maintain Predicted Diagnostic, Drug, and Vaccine Candidates.

A web-based resource CoronaVIR (https://webs.iiitd.edu.in/raghava/coronavir/) has been developed to maintain the predicted and existing information on coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have integrated multiple modules, including "Genomics," "Diagnosis," "Immunotherapy," and "Drug Designing" to understand the holistic view of this pandemic medical disaster. The genomics module provides genomic information of different strains of this virus to understand genomic level alterations. The diagnosis module includes detailed information on currently-in-use diagnostics tests as well as five novel universal primer sets predicted using in silico tools. The Immunotherapy module provides information on epitope-based potential vaccine candidates (e.g., LQLPQGTTLPKGFYA, VILLNKHIDAYKTFPPTEPKKDKKKK, EITVATSRTLS, GKGQQQQGQTV, SELVIGAVILR) predicted using state-of-the-art software and resources in the field of immune informatics. These epitopes have the potential to activate both adaptive (e.g., B cell and T cell) and innate (e.g., vaccine adjuvants) immune systems as well as suitable for all strains of SARS-CoV-2. Besides, we have also predicted potential candidates for siRNA-based therapy and RNA-based vaccine adjuvants. The drug designing module maintains information about potential drug targets, tertiary structures, and potential drug molecules. These potential drug molecules were identified from FDA-approved drugs using the docking-based approach. We also compiled information from the literature and Internet on potential drugs, repurposing drugs, and monoclonal antibodies. To understand host-virus interaction, we identified cell-penetrating peptides in the virus. In this study, state-of-the-art techniques have been used for predicting the potential candidates for diagnostics and therapeutics.

Effects of Probiotic Supplementation on Short Chain Fatty Acids in the AppNL-G-F Mouse Model of Alzheimer's Disease.

BACKGROUND: The intestinal microbiota and its metabolites, particularly short-chain fatty acids (SCFAs), have been implicated in immune function, host metabolism, and even behavior. OBJECTIVE: This study was performed to investigate whether probiotic administration influences levels of intestinal microbiota and their metabolites in a fashion that may attenuate brain changes in a mouse model of Alzheimer's disease (AD). METHODS: C57BL/6 wild-type (WT) mice were compared to AppNL-G-Fmice. The animals were treated with either vehicle or probiotic (VSL#3) for 8 weeks. Fecal microbiome analysis along with Aß, GFAP, Iba-1, c-Fos, and Ki-67 immunohistochemistry was done. SCFAs were analyzed in serum and brains using UPLC-MS/MS. RESULTS: Probiotic (VSL#3) supplementation for 2 months resulted in altered microbiota in both WT and AppNL-G-Fmice. An increase in serum SCFAs acetate, butyrate, and lactate were found in both genotypes following VSL#3 treatment. Propionate and isobutyrate were only increased in AppNL-G-Fmice. Surprisingly, VSL#3 only increased lactate and acetate in brains of AppNL-G-Fmice. No significant differences were observed between vehicle and VSL#3 fed AppNL-G-Fhippocampal immunoreactivities of Aß, GFAP, Iba-1, and Ki-67. However, hippocampal c-Fos staining increased in VSL#3 fed AppNL-G-Fmice. CONCLUSION: These data demonstrate intestinal dysbiosis in the AppNL-G-Fmouse model of AD. Probiotic VSL#3 feeding altered both serum and brain levels of lactate and acetate in AppNL-G-Fmice correlating with increased expression of the neuronal activity marker, c-Fos.

Vimentin as a potential therapeutic target in sorafenib resistant HepG2, a HCC model cell line.

BACKGROUND/AIMS: Hepatocellular carcinoma (HCC) is the most common liver cancer with high mortality rate in patients suffering from liver diseases. The drug of choice used in advanced-stage of HCC is sorafenib. However, adaptive resistance has been observed in HCC patients undergoing long-term sorafenib treatment, lowering its effectiveness. Hence, it is important to overcome drug resistance to improve overall management of HCC. Here, we have identified a candidate biomarker for sorafenib resistance in a HCC model cell line, HepG2. METHODS: Initially, comparative proteomic profiling of parental HepG2 [HepG2 (P)] and sorafenib-resistant HepG2 [HepG2 (R)] cells was performed via MALDI (matrix-assisted laser desorption/ionization) which revealed the deregulation of vimentin in HepG2 (R) cells. Gene and protein level expression of vimentin was also observed through quantitative real-time polymerase chain reaction (qRT PCR) and fluorescence-activated cell sorting (FACS), respectively. Furthermore, withaferin A was used to study regulation of vimentin expression and its significance in sorafenib resistance. RESULTS: Both gene and protein level of vimentin expression was found to be downregulated in HepG2 (R) in comparison to HepG2 (P). Interestingly, the study demonstrated that withaferin A further lowered the expression of vimentin in HepG2 (R) cells in a dose-dependent manner. Also, inhibition of vimentin lowered ABCG2 expression and decreased cell viability in parental as well as sorafenib resistant HepG2 cells. CONCLUSION: Hence, our study for the first time highlighted the probable therapeutic potential of vimentin in sorafenib resistant HepG2, a HCC model cell line.

Need of Palliative Care Services in Rural Area of Northern India.

BACKGROUND: Palliative care is comprehensive care that provides symptomatic relief and enhances the quality of life for people experiencing serious health-related suffering. There is an increasing need for palliative care services in India. Estimates for population requiring these services are essential in order to meet the increasing need for palliative care services. OBJECTIVES: The objective was to assess the proportion of population requiring and receiving palliative care services. MATERIALS AND METHODS: A descriptive cross-sectional research design was adopted for the study. The study was carried out in the village, Dhanas, Chandigarh. All the residents residing in the selected rural area were included in the study. Tools used for data collection were a screening questionnaire consisting of three questions, a sociodemographic sheet, a clinical profile, the Barthel Index of activities of daily living (ADL), and a pain rating scale. Analysis of the data was done using SPSS version 19 (IBM SPSS Statistics for Windows, Version 19.0.: IBM Corp). RESULTS: A total of 10,021 people from 884 households were screened in the study. The results revealed that the prevalence of need for palliative care services was 2/1000 population. None of the 19 participants with unmet palliative care needs were receiving any home- or institutional-based palliative care services at the time of assessment. Nearly, one-fourth of the participants had total dependency on caregivers for ADL. CONCLUSION: The study concluded that there is a need of palliative care services in the studied rural community of Chandigarh. These data can be used for planning and implementing community-based palliative care services in the studied area.

Effect of high-intensity ultrasound treatment on nutritional, rheological and structural properties of starches obtained from different cereals.

The ultrasonication was applied to four cereal starches namely wheat, barley, rice, and maize for two ultrasonication treatment durations, i.e., 15 and 30 min (T 15 and T 30, respectively) and were evaluated for their in vitro digestibility, XRD, FTIR spectroscopy, morphological and rheological properties. Ultrasonication increased the swelling power and solubility of starches from different cereals. For ultrasonicated starches (both raw and cooked), the RDS and RS content exhibited significant (P ≤ 0.05) an increase with an increase in treatment duration. RDS content exhibited an increase after both cooking and ultrasonication and ranged between 67.8 and 81.4%, whereas RS content declined with cooking and enhanced with ultrasonication and ranged between 2.3 and 3.1% after T 30 while SDS content decreased with increase in ultrasonication duration. FTIR spectra of ultrasonicated starches showed the characteristic broad peaks at 3351 to 3404 cm-1and to assigned to OH stretching of the hydroxyl group. The rheological properties showed an increase in G' and G″ for 15 min ultrasonication and decreased with 30 min ultrasonication. The main effects of ultrasonication were led to the formation of depressions and pores on the surface of starch granules, which were appropriately observed in wheat and maize starches.

Plumbago auriculata leaf extract-mediated AgNPs and its activities as antioxidant, anti-TB and dye degrading agents.

In the present work, silver nanoparticles have been biosynthesized by utilizing the alcoholic extract of Plumbago auriculata. The optimization of reaction conditions was carried out by monitoring the reactions with the help of UV-Visible absorption spectroscopy. The characterization of AgNP was carried out by infrared spectroscopy, transmission electron microscopy and X-Ray diffraction (XRD) studies. The biogenic AgNPs were tested against Mycobacterium tuberculosis using Microplate Almar Blue assay (MABA) and their antioxidant activity was also evaluated. The silver nanoparticles were also assessed for their reducing activity against organic dyes. The AgNPs were spherical in shape with size ranging from 15 to 45 nm with face centered cubic geometry as revealed by XRD analysis. The AgNPs possessed good antitubercular activity with MIC value of 1.6 µg/ml and these also exhibited promising antioxidant activity with IC50 value of 28.2. Furthermore, AgNPs also reduced congo red within 2 h and malachite green was degraded within 40 min. The present work demonstrated the utilization of P. auriculata for biosynthesis of AgNP which could be a potential candidate for antitubercular drug development and it could also be used as an antioxidant agent. The application of AgNP in reducing agent can be further extended and evaluated for purification of effluent water from textile industries.

Evaluation of evidence for pharmacokinetics-pharmacodynamics-based dose optimization of antimicrobials for treating Gram-negative infections in neonates.

BACKGROUND & OBJECTIVES: Neonates present a special subgroup of population in whom optimization of antimicrobial dosing can be particularly challenging. Gram-negative infections are common in neonates, and inpatient treatment along with critical care is needed for the management of these infections. Dosing recommendations are often extrapolated from evidence generated in older patient populations. This systematic review was done to identify the knowledge gaps in the pharmacokinetics-pharmacodynamics (PK-PD)-based optimized dosing schedule for parenteral antimicrobials for Gram-negative neonatal infections. METHODS: Relevant research questions were identified. An extensive electronic and manual search methodology was used. Potentially eligible articles were screened for eligibility. The relevant data were extracted independently in a pre-specified data extraction form. Pooling of data was planned. RESULTS: Of the 340 records screened, 24 studies were included for data extraction and incorporation in the review [carbapenems - imipenem and meropenem (n=7); aminoglycosides - amikacin and gentamicin (n=9); piperacillin-tazobactam (n=2); quinolones (n=2); third- and fourth-generation cephalosporins (n=4) and colistin nil]. For each of the drug categories, the information for all the questions that the review sought to answer was incomplete. There was a wide variability in the covariates assessed, and pooling of results could not be undertaken. INTERPRETATION & CONCLUSIONS: There is a wide knowledge gap for determining the doses of antimicrobials used for Gram-negative infections in neonates. A different profile of newborns in the developing countries could affect the disposition of antimicrobials for Gram negative infections, necessitating the generation of PK-PD data of antimicrobials in neonates from developing countries. Further, guidelines for treatment of neonatal conditions may incorporate the evidence-based PK-PD-guided dosing regimens.

Diabetes Care: Inspiration from Sikhism.

Religion has been proposed as a means of enhancing patient and community acceptance of diabetes and cultural specific motivational strategies to improve diabetes care. Sikhism is a young and vibrant religion, spread across the world and the Holy Scripture Sri Guru Granth Sahib (SGGS) is regarded as the living Guru by all Sikhs. The three key pillars of Sikhism are Kirat Karni (honest living), Vand Chakna (sharing with others) and Naam Japna (focus on God). They can help encourage the diabetes care provider, patient and community to engage in lifestyle modification, shared responsibility, positive thinking and stress management. The verses (Sabads) from the SGGS, with their timeless relevance, span the entire spectrum of diabetes care, from primordial and primary, to secondary and tertiary prevention. They can provide us with guidance towards a holistic approach towards health and lifestyle related diseases as diabetes. The SGGS suggests that good actions are based on one's body and highlights the relevance of mind-body interactions and entraining the mind to cultivate healthy living habits. The ethics of sharing, community and inclusiveness all lay emphasis on the need for global and unified efforts to manage and reduce the burden of the diabetes pandemic.

Platelet-rich fibrin: a boon in regenerative endodontics.

Research into regenerative dentistry has contributed momentum to the field of molecular biology. Periapical surgery aims at removing periapical pathology to achieve complete wound healing and regeneration of bone and periodontal tissue. Regenerative endodontic procedures are widely being added to the current armamentarium of pulp therapy procedures. The regenerative potential of platelets has been deliberated. Platelet-rich fibrin (PRF) is a wonderful tissue-engineering product and has recently gained much popularity due its promising results in wound healing bone induction. The features of this product are an attribute of platelets which, after cellular interactions, release growth factors and have shown application in diverse disciplines of dentistry. This paper is intended to shed light onto the various prospects of PRF and to provide clinical insight into regenerative endodontic therapy.

Antimicrobial Potential of Callistemon lanceolatus Seed Extract and its Statistical Optimization.

Plants have always been eminent source of medicinal products. Screening of the aqueous seeds extract of Callistemon lanceolatus (bottle brush) revealed its broad spectrum antimicrobial potential with an inhibition zone ranging from 13 to 28 mm against various pathogenic microorganisms. While optimizing the different parameters the antimicrobial activity was better expressed at 15 % concentration, prepared by extracting the material at 60 °C for 20 min. The extract was filtered through muslin cloth and gave best results at its natural pH. Statistical optimization by Response surface methodology enhanced the antimicrobial activity up to 1.6-fold. Minimum inhibitory concentration values of the aqueous extract of seeds of C. lanceolatus against different organisms ranged from 1-5 mg/ml. The viable cell count studies indicated a bactericidal effect against most of the pathogens. The aqueous extract was found to be relatively thermostable at 100 °C. When treated for shelf life at ambient conditions and refrigeration temperature (2-8 °C), the latter only showed a 28 % loss in antimicrobial activity. The aqueous extract was found to be biosafe when evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide reagent (MTT toxicity) assay and Ames mutagenicity assay.

The Role of Psychology in Pediatric Palliative Care.

Pediatric medicine increasingly has recognized the value of integrating behavioral health in medical care, but this trend has not yet extended to pediatric palliative care. Results from a recent survey of pediatric palliative care programs across the United States indicate that team composition almost never included a psychologist. This article presents a model of collaborative care to optimize the integration of psychosocial and medical aspects of treatment in pediatric palliative care, delineating how a psychologist adds to this model. This article argues that psychology brings specialized skills in assessment, intervention, and research that fit with the premise of palliative care as a holistic approach that relieves symptoms. Systematic inclusion of psychologists on pediatric palliative care teams may help to improve effectiveness of services as well as extend the knowledge base of mental health in pediatric palliative care.

Curcumin attenuates inflammatory response and cognitive deficits in experimental model of chronic epilepsy.

Evidence suggests that glial cells play a critical role in inflammation in chronic epilepsy, contributing to perpetuation of seizures and cognitive dysfunctions. The present study was designed to evaluate the beneficial effect of curcumin, a polyphenol with pleiotropic properties, on cognitive deficits and inflammation in chronic epilepsy. Kindled model of epilepsy was induced by administering sub-convulsive dose of pentylenetetrazole (PTZ) at 40 mg/kg, i.p. every alternative day for 30 days to Wistar rats. The animals were assessed for cognitive deficits by Morris water maze and inflammatory response in terms of microglial and astrocyte activation. PTZ treated animals had increased escape latency suggesting impaired cognitive functions. Further, an increased expression of astrocyte (GFAP) and microglial (Iba-1) activation markers were observed in terms of mRNA and protein levels in the PTZ treated animals. Concomitantly, mRNA and protein levels of pro-inflammatory cytokines (IL-1ß, IL-6, TNF-α) and chemokine (MCP-1) were increased in hippocampus and cortex. Immunoreactivity to anti-GFAP and anti-Iba-1 antibodies was also enhanced in hippocampus and cortex suggesting gliosis in PTZ treated animals. However, curcumin administration at a dose of 100 mg/kg to PTZ animals prevented cognitive deficits. A significant decrease in pro-inflammatory cytokines and chemokine expression was observed in hippocampus and cortex of PTZ treated rats supplemented with curcumin. In addition, curcumin also attenuated increased expression of GFAP and Iba-1 in animals with PTZ induced chronic epilepsy. Moreover, immunohistochemical analysis also showed significant reduction in number of activated glial cells on curcumin administration to PTZ treated animals. Taken together, these findings suggest that curcumin is effective in attenuating glial activation and ameliorates cognitive deficits in chronic epilepsy.

A Randomized Trial of 1% vs 2% Lignocaine by the Spray-as-You-Go Technique for Topical Anesthesia During Flexible Bronchoscopy.

BACKGROUND: The optimal concentration of lignocaine to be used during flexible bronchoscopy (FB) remains unknown. This randomized controlled trial compared the efficacy and safety of 1% and 2% lignocaine solution for topical anesthesia during FB. METHODS: Consecutive patients were randomized to receive either 1% or 2% lignocaine solution through the bronchoscope by the "spray-as-you-go" technique. The primary outcome of the study was the assessment of cough by the operator and the patient using the visual analog scale (VAS) and pain assessment using the faces pain rating scale. The secondary outcomes included total lignocaine dose, oxygenation status, adverse reactions related to lignocaine, and others. RESULTS: Five hundred patients were randomized (median age, 51 years; 71% men) 1:1 to either group. The median operator VAS score for cough was significantly higher (25 vs 21, P = .015) in the 1% group; however, the patient VAS score was not significantly different (32 vs 27, P = .065). The pain rating was similar between the two groups. The median cumulative dose of lignocaine was significantly higher in the 2% group (397 mg vs 312 mg, P = .0001; 7.1 mg/kg vs 5.7 mg/kg, P = .0001). About 28% of patients in the 2% group exceeded the maximum recommended dose (> 8.2 mg/kg) of lignocaine. No adverse event related to lignocaine overdose was seen in either group. CONCLUSIONS: One percent lignocaine was found to be as effective as 2% solution for topical anesthesia during FB, albeit at a significantly lower dose as the latter. Thus, 1% lignocaine should be the preferred concentration for topical anesthesia during FB. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT01955824; URL: www.clinicaltrials.gov.

Curcumin supplementation improves mitochondrial and behavioral deficits in experimental model of chronic epilepsy.

The present study was aimed to investigate the potential beneficial effect of curcumin, a polyphenol with pleiotropic properties, on mitochondrial dysfunctions, oxidative stress and cognitive deficits in a kindled model of epilepsy. Kindled epilepsy was induced in rats by administering a sub-convulsive dose of pentylenetetrazole (PTZ, 40 mg/kg body weight) every alternate day for 30 days. PTZ administered rats exhibited marked cognitive deficits assessed using active and passive avoidance tasks. This was accompanied by a significant decrease in NADH:cytochrome-c reductase (complex I) and cytochrome-c oxidase (complex IV) activities along with an increase in ROS, lipid peroxidation and protein carbonyls. The levels of glutathione also decreased in the cortex and hippocampus. Electron micrographs revealed disruption of mitochondrial membrane integrity with distorted cristae in PTZ treated animals. Histopathological examination showed pyknotic nuclei and cell loss in the hippocampus as well as in the cortex of PTZ treated animals. Curcumin administration at a dose of 100 mg/kg, p.o. throughout the treatment paradigm was able to ameliorate cognitive deficits with no significant effect on seizure score. Curcumin was able to restore the activity of mitochondrial complexes. In addition, significant reduction in ROS generation, lipid peroxidation and protein carbonyls was observed in PTZ animals supplemented with curcumin. Moreover, glutathione levels were also restored in PTZ treated rats supplemented with curcumin. Curcumin protected mitochondria from seizure induced structural alterations. Further, the curcumin supplemented PTZ rats had normal cell morphology and reduced cell loss. These results suggest that curcumin supplementation has potential to prevent mitochondrial dysfunctions and oxidative stress with improved cognitive functions in a chronic model of epilepsy.